Ariz. Admin. Code § 4-20-102

Current through Register Vol. 30, No. 45, November 8, 2024

Section R4-20-102 - Application for a Dispensing Optician's License by Examination

At least 30 days before a regularly scheduled board meeting date, an applicant for a dispensing optician's license by examination shall submit to the Board an application packet that contains:

1. An application form provided by the Board, signed and dated by the applicant, that contains:

a. The applicant's name, Social Security number, address, and telephone number;

b. The name and address of the applicant's employer at the time of application, if applicable;

c. If demonstrating technical skill and training under A.R.S. § 32-1683(5)(b), the name and address of each dispensing optician, physician, or optometrist for whom the applicant served as an apprentice for three of the six years immediately preceding the application date, and the beginning and ending dates of each apprenticeship;

d. If demonstrating technical skill and training under A.R.S. § 32-1683(5)(c), the name and address of the school from which the applicant graduated, dates of attendance, date of graduation, degree received, and the name and address of each dispensing optician for whom the applicant served as a dispensing optician apprentice for one of the six years immediately preceding the application date and the beginning and ending dates of service. The applicant shall submit a photocopy of the applicant's diploma from the optical dispensing school;

e. If demonstrating technical skill and training under A.R.S. § 32-1683(5)(c) received during military service, the name and address of the school from which the applicant graduated, dates of attendance, date of graduation, and degree received, the location and name of the duty station at which the applicant has worked for three of the six years immediately preceding the application date and the beginning and ending dates of service.

f. If demonstrating technical skill and training under A.R.S. § 32-1683(5)(d), the name and address of each dispensing optician, physician, or optometrist for whom the applicant has worked for three of the six years immediately preceding the application date and the beginning and ending dates of employment;

g. A statement of whether the applicant has ever been convicted of a felony or of a misdemeanor involving moral turpitude in any state;

h. A statement of whether the applicant has ever had an application for a professional license denied or had a license suspended or revoked in any state; and

i. A sworn statement by the applicant verifying the truthfulness of the information provided by the applicant;

2. A photocopy of the applicant's:

a. High school diploma or general educational diploma issued in any state; or

b. Transcripts from a high school or college; or

c. Evidence of a college degree or admission to any college in any state;

3. Verification of passing both spectacle and contact lens written and practical examinations in opticianry administered by a nationally recognized body as evidenced by an original notice of examination results or a copy of the original certificate of passage issued by the organization that prepared the examination;

4. A letter attesting to good moral character from each of three individuals who are not family members, who have known the applicant for two years immediately before the date of the application, and support the applicant's licensure;

5. A letter from each physician, optometrist, or dispensing optician named in subsection (1)(c), (d), or (e) that contains:

a. The individual's printed name, address, and telephone number; and

b. A statement that the applicant has either served as an apprentice or been employed as a dispensing optician by the physician, optometrist, or dispensing optician for the time required in subsection (1)(c), (d), or (e);

6. A photograph of the applicant taken not more than six months before the date of application; and

7. The fee required in R4-20-112.

Ariz. Admin. Code § R4-20-102

Former Rule III. Amended effective August 9, 1977 (Supp. 77-4). Amended effective August 7, 1978 (Supp. 78-4). Amended effective December 14, 1979 (Supp. 79-6). Former Section R4-20-103 repealed, new Section R4-20-103 adopted effective October 24, 1983 (Supp. 83-5). Former Section R4-20-103 amended and renumbered as Section R4-20-102 effective September 18, 1987 (Supp. 87-3). Amended effective September 13, 1989 (Supp. 89-3). Section R4-20-102 repealed, new Section adopted by final rulemaking at 5 A.A.R. 423, effective January 15, 1999 (Supp. 99-1). Amended by final rulemaking at 11 A.A.R. 3660, effective November 15, 2005 (Supp. 05-3). Amended by final rulemaking at 19 A.A.R. 584, effective May 5, 2013 (Supp. 13-1). Amended by final rulemaking at 24 A.A.R. 3418, effective 12/4/2018. Amended by final rulemaking at 27 A.A.R. 2727, effective 11/4/2021.